Comparative Efficacy and Relative Ranking of Biologics and Oral Therapies for Moderate-to-Severe Plaque Psoriasis : A Network Meta-analysis
Armstrong, April W. (University of Southern California. Department of Dermatology, Keck School of Medicine)
Soliman, Ahmed M. (AbbVie, Inc)
Betts, Keith A. (Analysis Group, Inc)
Wang, Yan (Analysis Group, Inc)
Gao, Yawen (Analysis Group, Inc)
Puig Sanz, Lluís (Institut d'Investigació Biomèdica Sant Pau)
Augustin, Matthias (University Medical Center Hamburg-Eppendorf)
Universitat Autònoma de Barcelona

Fecha:	2021
Resumen:	The clinical benefits of biologic and oral treatments for moderate-to-severe plaque psoriasis are well-established, but efficacy outcomes can vary across therapies. Comparative efficacy analysis can be highly informative in clinical settings with multiple therapeutic options. This study assessed the short-term and long-term comparative efficacy of biologic and oral treatments for moderate-to-severe psoriasis. A systematic literature review identified phase 2/3/4 randomized controlled trials (RCTs) through to 1 July 2020 for Food and Drug Administration- or European Medicines Agency-licensed treatments for moderate-to-severe psoriasis. Psoriasis Area and Severity Index (PASI) 75/90/100 response rates at the end of the primary response (short-term: 10-16 weeks from baseline) and maintenance periods (long-term: 48-52 weeks from baseline) were estimated using Bayesian network meta-analysis. Surfaces under the cumulative ranking curves (SUCRA) were estimated to present the relative ranking of treatments. In the short term (N = 71 RCTs), the PASI 90 response rates were highest for ixekizumab (72. 9%, SUCRA 0. 951), risankizumab (72. 5%, 0. 940), and brodalumab (72. 0%, 0. 930), which were significantly higher than those for guselkumab (65. 0%, 0. 795), secukinumab (65. 0%, 0. 794), infliximab (56. 8%, 0. 702), certolizumab (400 mg: 49. 6%, 0. 607; 200 mg: 42. 2%, 0. 389), ustekinumab (90 mg: 47. 9%, 0. 568; weight-based: 45. 7%, 0. 505; 45 mg: 44. 6%, 0. 460), adalimumab (43. 0%, 0. 410), tildrakizumab (200 mg: 39. 7%, 0. 327; 100 mg: 37. 2%, 0. 268), etanercept (18. 0%, 0. 171), apremilast (12. 4%, 0. 090), and dimethyl fumarate (12. 2%, 0. 092). The PASI 100 response rates were highest for ixekizumab (41. 4%), risankizumab (40. 8%), and brodalumab (40. 3%). In the long term (N = 11 RCTs), the PASI 90 rate was highest for risankizumab (85. 3%, SUCRA: 0. 998), which were significantly higher than those for brodalumab (78. 8%, 0. 786), guselkumab (78. 1%, 0. 760), ixekizumab (72. 1%, 0. 577), secukinumab (67. 0%, 0. 450), ustekinumab (weight-based: 55. 0%, 0. 252), adalimumab (51. 6%, 0. 176), and etanercept (37. 9%, 0. 001). Risankizumab had the highest PASI 100 response rate (65. 4%), followed by brodalumab (55. 7%) and guselkumab (54. 8%). Ixekizumab, risankizumab, and brodalumab had the highest short-term efficacy, and risankizumab had the highest long-term efficacy. The online version contains supplementary material available at 10. 1007/s13555-021-00511-1.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Biologic therapies ; Network meta-analysis ; Plaque psoriasis
Publicado en:	Dermatology and Therapy, Vol. 11 (march 2021) , p. 885-905, ISSN 2190-9172

DOI: 10.1007/s13555-021-00511-1
PMID: 33788177

21 p, 1000.2 KB

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